Active NPI
David Alan Paulson, M.D.
- Internal Medicine Physician
- St. Paul, MN
National Provider Identifier
1154312130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 21629
- Practice address
- Minnesota Deparrtment of Corrections
1450 Energy Park Drive
St. Paul, MN 55108 - Phone
- (651) 603-0170
- NPI assigned
- Oct 31, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 21629 | MN | Primary |
Addresses
Primary practice location
Minnesota Deparrtment of Corrections
1450 Energy Park Drive
St. Paul, MN 55108
Mailing address
Minnesota Deparrtment of Corrections
1450 Energy Park Drive
St. Paul, MN 55108
Phone (651) 603-0170
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21629 | MN | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1154312130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MINNESOTA DEPARRTMENT OF CORRECTIONS",
"address_2": "1450 ENERGY PARK DRIVE",
"city": "ST. PAUL",
"state": "MN",
"postal_code": "55108",
"telephone_number": "651-603-0170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MINNESOTA DEPARRTMENT OF CORRECTIONS",
"address_2": "1450 ENERGY PARK DRIVE",
"city": "ST. PAUL",
"state": "MN",
"postal_code": "55108",
"telephone_number": "651-603-0170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAULSON",
"first_name": "DAVID",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-31",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MN",
"license": "21629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St. Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.